Malaria continues to be a major killer of under-fives, and Tanzania has set strategies to reduce malaria in the country. To complement and support government efforts to reduce morbidity and mortality of under-fives, in 2011 the United States Agency for International Development (USAID) created the Tibu Homa Project (THP) to improve diagnosis and treatment of febrile illnesses among children under five years of age in the Lake Zone of Tanzania. THP is led by University Research Co., LLC (URC) working in partnership with Amref Health Africa and Management Sciences for Health (MSH).

THP is operational in 28 districts of six regions in the Lake Zone: Kagera, Mwanza, Geita, Mara, Shinyanga, and Simiyu. Studies have shown that despite introduction of malaria rapid diagnostic tests (mRDT), presumptive treatment of malaria and non-adherence to test results is still practiced in Tanzania (URT 2008; Mubi et al. 2013). Therefore, in order to improve quality of care, the project included among other improvement activities, capacity building in malaria testing and treatment according to national policy. This paper reports on the THP experience in improving malaria testing so as to improve case management among children under five years of age during the period 2012-2014.